Friday, August 21, 2009

A touch

My local oncologist, Dr. S, will never be my friend, but I respect her deeply. She's prim and organized, qualities mysterious to me. She laughs at my jokes, which I appreciate. Beyond this, though, she maintains scrupulous personal distance. She's not unfriendly, just aloof.

And yet, when I fell into crisis at the end of June, it was her I was desperate to see.

I throw around a lot of scary, chewy words and ideas here. Cancer has hyped up my emotional expressiveness in ways very good and very bad. But I think this truly was a crisis. I had an almost nonexistent appetite, and eating was a painful chore because my mouth was peppered with little sores and sensitivities. Pounds were sluicing off my too-thin frame. I couldn't sleep at appropriate times. My pain felt uncontrollable.

My breathing, which hadn't been easy for more than a year, had deteriorated slowly but relentlessly. I took the problem for granted even though I was dimly aware that it was neither normal nor acceptable, even for a cancer patient, to be unable to walk from the living room into the kitchen without hunkering down to pant some place along the way.

Some evenings, as pain seemed to drip from the tumor in my hip like poisoned rain and pool in my lower leg and foot, I would just sit and sob as L. tried everything she could think of to help until she, too, was sobbing. My physical problems were formidable, my mental issues insidious. The constant strain either put me into a major situational depression or, more likely, converted a longstanding chronic depression into something fiercer and more debilitating.

I somehow knew I needed Dr. S, and L. somehow got us an appointment almost instantly. As I slumped in a chair and mumbled, Dr. S grasped the essentials and quickly made a sensible and comprehensive plan. The appointment ended with two profundities and a pile of prescriptions. The first profound thing was a referral to the palliative care unit of the Visiting Nurse Association, which I am going to be talking a lot about.

The second was that she touched me. I couldn't recall Dr. S ever doing that outside an exam or handshake.

For some reason, as she talked plainly and kindly about how long and hard my illness had been (thoughts I try not to let into my mind), she felt moved to conclude by reaching out awkwardly and patting my shoulder. I was out of it, but engaged enough to be surprised.

Her hand, I felt at the time, almost burned with portent.

Good or bad I could not say.

I'm hoping to write about a half-dozen posts about the experience of starting palliative care while still pursuing a curative option, brivanib. Even though changing focus to palliative efforts is nothing like entering hospice, I found the decision fraught and worth writing about. Posts in the series will be tagged "palliativecare" at the bottom. And need I even say that L. was way smarter about this long before I was?

No comments: